NPIMap

Organization Active NPI

Coast Physical Therapy & Coast Rehab

Doing business as Patriot Physical Therapy

  • Physical Therapist
  • Rancho Palos Verdes, CA
National Provider Identifier
1740563402
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
COAST PHYSICAL THERAPY & COAST REHAB
Doing business as
Patriot Physical Therapy
Practice address
28901 S Western Ave Ste 103
Rancho Palos Verdes, CA 90275-0001
Phone
(310) 732-0036
Fax
(310) 732-0250
NPI assigned
Sep 20, 2011
Organization subpart
Yes
Parent organization
PATRIOT PHYSICAL THERAPY INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Simon Bonzo
Title
Ceo
Phone
(310) 732-0036

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

28901 S Western Ave Ste 103
Rancho Palos Verdes, CA 90275-0001

Mailing address

28901 S Western Ave Ste 103
Rancho Palos Verdes, CA 90275-0001
Phone (310) 732-0036

Other names 1

  • PATRIOT PHYSICAL THERAPY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coast Physical Therapy Coast Rehab2 organizations share this tax ID, including this one
Part of
Coast Physical Therapy Coast Rehab

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

29050 S Western Ave
Ste 155
Rancho Palos Verdes, CA 90275
Phone (310) 732-0036

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711497600000",
    "number": "1740563402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28901 S WESTERN AVE STE 103",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750001",
            "telephone_number": "310-732-0036",
            "fax_number": "310-732-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28901 S WESTERN AVE STE 103",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750001",
            "telephone_number": "310-732-0036",
            "fax_number": "310-732-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST PHYSICAL THERAPY & COAST REHAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATRIOT PHYSICAL THERAPY INC.",
        "enumeration_date": "2011-09-20",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A",
        "authorized_official_last_name": "BONZO",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-732-0036"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATRIOT PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PATRIOT PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Palos Verdes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.